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TPA Urges NY State Legislature to Reject S428 & A47

Tim Andrews

June 10, 2019

June 10, 2019

New York State LegislatureAlbany, NY 12224

Dear Legislator:

On behalf of millions of taxpayers and consumers across the state of New York, the Taxpayers Protection Alliance (TPA) urges you to reject S428 & A47 which would ban the sale of flavored e-cigarette products in the state. All credible academic research on the subject demonstrates that youth non-smokers are simply not attracted to vaping products due to the use of flavorings, however it does help millions of adults successfully quit smoking traditional combustible cigarettes. As such, if enacted, these bills would seriously damage public health in New York by preventing millions of smokers from quitting the dangerous habit of using combustible cigarettes.

The weight of the evidence overwhelmingly demonstrates that e-cigarettes are a tried, tested, and safe way for people to quit smoking. Internationally, the United Kingdom (UK) Government and all major medical bodies now “encourage” smokers to use e-cigarettes as a quit-smoking aid. Similarly, the US Food & Drug Administration announced support for e-cigarettes as a part of a comprehensive, nationwide tobacco harm reduction strategy. The US Cancer Society recommends that doctors advise their patients to quit smoking using e-cigarettes, as does Cancer Research UK, which strongly advises smokers to switch to the lower-harm product. A recent US National Academies of Sciences, Engineering and Medicine report on e-cigarettes also found that, based on the available evidence, “e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes.

This is hardly surprising, given the overwhelming evidence on the effectiveness of a product that is “around 95 percent less harmful than smoking,” and that e-cigarettes also pose no threat to bystanders via “passive smoking.” Numerous studies have shown that e-cigarettes are considerably more effective than traditional nicotine replacement therapies such as nicotine gums and patches. In January 2019, the New England Journal of Medicine reported the results of the largest and most comprehensive of these, finding unequivocally that e-cigarettes are nearly twice as effective as conventional nicotine replacement products (such as patches and gum) for quitting smoking. As such, the State of New York should be doing everything in its power to encourage people to quit smoking through the use of e-cigarettes.

As a result of the introduction of vaping products, smoking rates in New York have fallen significantly in recent years. According to the latest available survey data (from 2016), the statewide adult smoking rate is 14.2 percent — a 22 percentage-point decline from 2011, while the smoking rate for all New York City residents also dropped significantly from 16.2 percent in 2011 to 11.5 percent in 2016. Even more impressively, during that time period, smoking among 18- to 24-year-olds dropped from 21.6 percent to 11.7 percent. The continued significant decline in tobacco consumption should be encouraged, and not condemned by state authorities.

In fact, according to the most comprehensive peer-reviewed research on the effects of switching, if a majority of smokers in New York quit smoking through the use of e-cigarettes over the next ten years, more than 175,000 lives would be saved. If passed, these bills threaten to reverse the trend away from traditional consumption, as people return to smoking harmful combustible cigarettes.

The sponsors fail to appreciate that flavored tobacco is key to helping people transition from combustible cigarettes to safer alternatives. Existing survey evidence supports the idea that, amongst the general smoking public on the whole, flavors induce substitution from traditional cigarettes to reduced-risk e-cigarettes. A 2016 survey of more than 27,000 e-cigarette users by Consumer Advocates for Smoke-Free Alternatives Association found that nearly three-quarters (72 percent) of respondents “credited tasty flavors with helping them give up tobacco.” This shows that e-cigarettes may truly be providing all smokers an exit ramp away from traditional, more harmful tobacco products.

While flavors may be helping conventional smokers quit smoking, the evidence shows that it plays little to no role in inducing middle-and-high school students to use e-cigarettes. A 2012 study published in the Journal of Adolescent Health found no statistically significant difference between flavored and unflavored e-cigarettes in piquing the interest of teenagers (in this case, adolescent males). These findings were again confirmed by a 2016 study published in Tobacco Control that used a national phone survey to ascertain teenage usage and interest in e-cigarettes and attempted to gauge the role of flavor in increasing interest in these products. The researchers found that, of teenagers that have never smoked, only 3.3 percent expressed interest in trying e-cigarettes and that there was no evidence for flavors driving e-cigarette uptake. As such, given that the scientific literature demonstrates that flavors are not a decisive factor in youth taking up e-cigarettes, but are helpful for traditional smokers quitting. The state’s case for banning flavored product is not only without foundation, but is downright damaging to public health.

We further note that contrary to anti-vaping arguments, there is no evidence that e-cigarettes provide a “gateway” to smoking for youths as they enter adulthood, and that this has demonstrated through numerous studies which instead find that vaporized nicotine has almost exclusively been taken up by smokers attempting to quit or lower their intake, therefore acting as a “gateway” away from tobacco smoking. As recently as April 2, 2019 a study funded by the UK’s National Institute for Health Research led by Cardiff University and conducted in collaboration with academics from Edinburgh, Stirling, Glasgow and Bristol canvassed the views of almost 250,000 young people. It concluded that there is “that fears over a resurgence in youth tobacco smoking because of the rise in e-cigarette use are largely unfounded to date” and that there is “no evidence” that e-cigarettes are causing young persons to commence smoking traditional combustible tobacco. Previously, a 2014 study in the American Journal of Preventive Medicine found that the few nicotine vape users who were not smoking previously used the product only 1-2 days a week, indicating that any residual harm from legalized nicotine vaping is minimal. Evidence from large, national cross-sectional studies also show no evidence that vaping uptake increases the ranks of future smokers in countries where nicotine vaping is legal. We also note that nicotine patches and gums have existed and been approved for smokers as young as 12 years old for 30 years, yet no evidence of adverse effects on adolescent brain development has emerged.

Figures which purport to show that e-cigarettes are providing an on-ramp for non-smoking teenagers that would otherwise lead smoke-free lives have been debunked by newer, better evidence. Survey data finds that “never-smokers” comprise a tiny minority of e-cigarette users in young persons.The researchers find that, by far, the biggest predictor of current e-cigarette usage is current cigarette usage, followed by cigarette usage at some point in the past. Amongst ever-smokers and current smokers, current e-cigarette usage rates are 23.5 percent and 64.1 percent respectively.

As a consumer and taxpayer advocacy group, we encourage New York legislators to make decisions that are in the best interest of the consumer. All available evidence confirms that adults are using flavored products to quit conventional tobacco products and that flavors are an important part of this trend, while not affecting youth uptake. As such the State of New York should take an approach consistent with the science to allow for innovations that could help wean smokers off conventional products. There is no reason to keep these flavored products from the public and we urge space for innovation instead of prohibition.